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“A curriculum is like water. It has the tendency to seek the lowest level of energy it can reach, and without constant renewal, it will stagnate and become putrid. To avoid stagnation alone is justification for action.”

It is useful to select one model of clinical reasoning and base the tutorial discussion on it. The precise model is less important than its generic use as a framework to structure the flow of discussion. It later serves as a fall-back strategy in complicated clinical situations.

Both medical textbooks and classroom teaching abound in the limitless presentation of detailed lists of disorders. More often, both fail to provide a categorization scheme that is best suited for their retrieval in a clinical problem solving situation.

The purpose of basic science teaching is to provide a scientific foundation for tasks of clinical practice such as diagnosis and therapeutics. The essential challenge of balancing depth of understanding with breadth of coverage remains.

Clinical reasoning does not develop in isolation: it is associated with increasingly refined and elaborated medical knowledge. Problem solving is domain-specific and not generic, so the challenge for medical educators is not only to make explicit the process of reasoning but also to identify the necessary content.

"Faculty members own what is taught in the curriculum - they own the content. The Associate Dean and Curriculum Committee are responsible for the methods and the effectiveness. Faculty give the course, the Associate Dean has to give the degree.”